Prostate cancer, the most common type of cancer in men, can be terrifying and life-threatening. As with all debilitating diseases, the consequences of prostate cancer go beyond the physical – it can impact mood, interpersonal relationships, even sex life. For many men and their spouses, the question is: how will this diagnosis impact their intimate relationships? In this post, we’ll talk about the connection between prostate cancer and sexual health, focusing on how treatment can alter sexual function and how couples can navigate this unfamiliar territory.
Understanding Prostate Cancer
The prostate, a walnut-shaped gland just below the bladder, produces seminal fluid that feeds and transports sperm. Prostate cancer is the process where normal prostate cells develop into malignant cells. It doesn’t know what causes it, but age, history, ethnicity and certain mutations in genes are risk factors.
Prostate cancer, like any other cancer, elicits a tsunami of reactions: fear, anxiety, anger and uncertainty are all common responses. Patient attention tends to be focused on the immediate impact of the disease itself: staging, treatment, mortality and adverse events. But prostate cancer’s effect on sex is something we should consider.
Treatments and Their Side Effects
Prostate cancer treatments include active surveillance, surgical interventions, radiation, hormone therapy, and chemotherapy. Any treatment has potential side effects, especially when it comes to sex.
1. Surgery
Surgical surgery, including radical prostatectomy, is an increasingly prevalent form of treatment for localized prostate cancer. In this procedure, the prostate gland and parts of its surrounding tissues are removed. It can be a powerful method of killing cancer cells, but the risks are substantial. Erectile Dysfunction (ED) is one of the most commonly experienced post-operative problems. Penilenerectic nerves, the nerves that produce penile erections, can be damaged during the operation. While nerve-sparing techniques can still save erectile function, not every patient can benefit from such treatments, depending on the extent of the cancer.
Men can experience mild ED or full erectile dysfunction, and the level of nerve damage varies significantly between men. Modifications in orgasm and ejaculation, including “dry orgasms” (orgasm without ejaculation), can also alter sexual intimacy and pleasure.
2. Radiation Therapy
The other popular treatment option is radiation therapy, which includes external beam radiation and brachytherapy (internal radiation). It works to treat prostate cancer, but it also has side effects. Erectile dysfunction often develops over time, sometimes months after treatment has ended. Patients may also experience lower libido and changes in ejaculation, which have a devastating impact on their sexual health and relationships.
One feature of the side effects of radiation therapy is that they might not show up immediately but develop in time, creating fear and uncertainty among patients as they cope with the pain of recovery and watch their sexual lives unfold.
3. Hormone Therapy
Hormone therapy is typically used to decrease levels of male hormones (androgens) like testosterone that promote the development of prostate cancer cells. This can be a powerful cancer prevention tactic, but hormonal shifts that occur during treatment can cause significant sexual concerns. The average men receiving hormone therapy experience decreased libido, and this often complicates sexual relations. Men also suffer from erectile dysfunction, and additional physical changes like breast enlargement and weight gain can compound a man’s sense of body image and sexual self-worth.
Such shifts can be psychologically extreme, and lead to feelings of unworthiness or depression that might affect sex and intimacy.
4. Chemotherapy
Chemotherapy is typically reserved for advanced prostate cancers that have spread outside the prostate. Not typically related to directly sexual side effects, however, the overall physical and emotional impact that chemotherapy exerts on a person can affect sexual function. Sickness, vomiting, and other physical conditions decrease libido and performance. Second, chemotherapy affects mental wellbeing – possibly anxiety and depression – and can impair sexual function as well.
Psychological and Emotional Aspects
A prostate cancer diagnosis can leave a psychological scar. After treatment for cancer, men suffer from low self-esteem, body image and identity. Men generally appear weak or less masculine, and this has a significant impact on libido and performance.
It is even more difficult to make sense of when you look at it from the other person’s perspective. A spouse may want to intervene but be unsure of how to approach sex without creating more harm. You need to talk, as sharing fears, wishes and needs opens up the opportunity for reconciliation.
Navigating Changes in Sexual Function
Prostate cancer will certainly affect sex health, but it’s essential that you embrace those struggles, not turn a blind eye to them. Here are a few steps couples can take to adjust to the new reality:
1. Open Communication
Open communication is the cornerstone of any good sexual relationship. Couples should talk about what they fear, what they want and what they want during and after treatment. This honesty fosters trust and perhaps even emotional closeness.
2. Consult Healthcare Professionals
Those who have prostate cancer and are undergoing treatment for prostate cancer should never be afraid to discuss sex with their physicians. Erectile dysfunction can be treated by a wide variety of methods, from orally administered medications (such as Viagra or Cialis) to vacuum pumps, injections and penile implants. A thorough knowledge of all the treatment options can mitigate anxiety.
3. Explore Alternate Intimacy
Penetrative sex isn’t always the key to intimacy. Couples might also pursue other kinds of physical intimacy – kissing, touch, cuddling – that can foster intimacy but do not involve sexual play. In many cases, these other sexual practices restore the intimacy between couples.
4. Consider Counseling
It helps to get professional advice from time to time. Sex therapy or couples counseling can allow couples to explore their psychological barriers to sex. A trained therapist can offer interventions and strategies that allow both partners to articulate unfulfilled needs and gather tools to adapt to their new reality.
5. Adjust Expectations
Both partners should adjust their expectations of closeness. Prostate cancer will come with bumps and bruises, and it can be liberating to accept that love can change. The ability to establish healthy goals when it comes to sex will ease the stress and make it feel better.
Support Networks
There can also be a sense of community and connection through support groups. Most cancer hospitals have support groups specifically dedicated to men with prostate cancer and their partners. Communicating with others who have experienced it can help you to avoid isolation and heal.
Conclusion: Will Prostate Cancer Affect Your Sex Life?
Prostate cancer unpredictably transforms all aspects of life, not least sexual life. Nonetheless, although erectile dysfunction and intimacy shifts are a real possibility, knowing what’s happening lets us take steps to remedy it. By making sure you communicate, looking at alternatives to penetrative sex, and consulting professionals, couples can go through this difficult process together. Prostate cancer can shake up relationships, but it can also open up a space for development, for patience, and for deeper emotional connections. By learning and providing resources, partners can learn to embrace their new reality, which shows us that intimacy is more than just the body, but based on love, respect and companionship, that endures the most extreme challenges.
